Prescription Management | Request refills or transfers for prescription drugs

Start your request for a Transfer, Refill, or New Prescriptions below.

At Alpha Pharmacies, we make Refills & Transfers a Breeze! We take all Major Insurances, your Co-Pays stay the same & We offer the Best Cash Prices on all Medications.

To Refill:
Call, Walk-in, or choose Auto Refill. We will have you medications ready to be picked up or delivered in no time.

To Transfer:
Call, Walk-in with your Bottles, or fill out the Form Below & we do the rest!

To Fill New Prescriptions:
Walk it in or have it Faxed from Physician Office, Phoned in by Physician or Nurse, or Electronically Sent (e-RX or e-Script) from Physician Office.

prescription refills

Returning Customer? Call us to Refill your Prescriptions.

RX Refill

transfer a prescription

New to the Alpha Pharmacies? Fill out your information below & we would be happy to transfer your prescriptions. Call us if you have any questions. (714) 220-0373

Patient information

Patient's First Name*

Patient's Last Name*

Email Address*

Gender*

Date of Birth*

Address*

City*

State*

Zip Code*

Preferred Alpha Pharmacy Location*

Phone

(Example: 123-456-7890)*

We will contact you at this number as soon as your prescription is ready to be picked up.
Please allow 12-24 hours for us to transfer and process your prescription. We’re glad to have you as part of the Alpha Family.

Insurance information

Enter prescription insurance coverage information as it appears on your card

Name of Insurance*

First Name*

Last Name*

Member ID*

Group Number*

BIN Number*

PCN Number*

Prescription information

Enter prescription information as it appears on the prescription label

Pharmacy Name*

Pharmacy Address*

Pharmacy City*

Pharmacy State*

Pharmacy Zip Code*

Pharmacy Phone*

Prescription Number*

Prescription Doctors Name*

Doctors Phone*

Drug Name*

Drug Strength*

Add another prescription

Additional Prescription 1